Speaker 1: Pushkin, this is solvable. I'm Jacob Weisberg. We have made
Speaker 1: a valiant effort to make sure that black scientists have
Speaker 1: been at the table of the vaccine discovery and development,
Speaker 1: the valuation of the data in the clinical trials, and
Speaker 1: then the decisions at the FDA CDC of the allocation.
Speaker 1: Even with such concerted efforts and successes with bringing black
Speaker 1: scientists to the table, many people of color in the
Speaker 1: United States still express hesitation about receiving the new COVID
Speaker 1: nineteen vaccine. Americans of color serve in essential jobs across society,
Speaker 1: which makes it even more urgent that they be vaccinated.
Speaker 1: They were to people who check people into the emergency room.
Speaker 1: They are the orderly, they are the ones in flood service,
Speaker 1: they are the ones in transport, so you know that
Speaker 1: they were at increased risk or being infected. According to
Speaker 1: the CDC, black Americans are one point four times as
Speaker 1: likely to be infected with COVID nineteen. Indigenous, Black and
Speaker 1: Latin X Americans are at least two point seven times
Speaker 1: more likely to die than their white neighbors, according to
Speaker 1: American Public Media Research Lab. As COVID nineteen vaccines roll
Speaker 1: out across the country. The medical establishment faces this problem.
Speaker 1: How do you re establish trust or establish it in
Speaker 1: the first place. If there's ever a time to understand
Speaker 1: history and to understand how that has influence people's ability
Speaker 1: to trust the health system, the time is now. Doctor
Speaker 1: Valerie Montgomery Rice is the president and dean of the
Speaker 1: Morehouse School of Medicine. She was among the first people
Speaker 1: to be vaccinated in the United States. Her shot with
Speaker 1: broadcast live on CNN. She thinks this is a problem
Speaker 1: we can solve. I believe that we can move from
Speaker 1: vaccine hesitancy to vaccine certainty. Doctor Montgomery Rice, I'm so
Speaker 1: happy to be able to talk to you about this today.
Speaker 1: You know, I think a lot of us have been
Speaker 1: watching the catastrophe within the catastrophe or one of them,
Speaker 1: which is that COVID nineteen has disproportionately infected people of color,
Speaker 1: and I think even more disproportionately killed people of color.
Speaker 1: You know, one would hope in that situation that African
Speaker 1: Americans would be at the front of the line to
Speaker 1: get their vaccines. And I wonder if you can talk
Speaker 1: for a minute about where we are and why African
Speaker 1: Americans are in some cases more reluctant than others to
Speaker 1: get the vaccine. We know that this virus has disproportionately
Speaker 1: impacted people of color, not just African Americans, but Latin
Speaker 1: X and questions were raised early on, was there something
Speaker 1: unique about race or ethnicity that put people at greater risk.
Speaker 1: What we really recognize when you looked at the science
Speaker 1: that this virus did not discriminate that if you were
Speaker 1: in proximity with someone who was infected, you had a
Speaker 1: higher chance of being infected. Latin X and African American
Speaker 1: were the people who were the essential workers because they
Speaker 1: are the people who check people into the emergency room,
Speaker 1: they are the orderly, they're the ones in food service,
Speaker 1: they're the ones in transport driving your buses, who were
Speaker 1: picking up your trash, who were working in restaurants, etc.
Speaker 1: So you know that they were at increased risk of
Speaker 1: being infected. So it was not that this virus was
Speaker 1: discriminatory per se against people because of their race ethnicity.
Speaker 1: It's the social determinants they have led to this. Now,
Speaker 1: having said all of that, we know that we see
Speaker 1: a disproportion number of health disparities because of the social
Speaker 1: constructs that have not allowed for greater access to care
Speaker 1: and then access to the greatest level of quality of care.
Speaker 1: And so we have made a valiant effort in the
Speaker 1: science community to make sure that black scientists have been
Speaker 1: at the table of the vaccine discovery and development, the
Speaker 1: valuation of the data in the clinical trials, and then
Speaker 1: the decisions at the FDA and CDC of the allocation. Yeah,
Speaker 1: and of course people saw you getting your first dose
Speaker 1: of the vaccine on CNN, and one of the other
Speaker 1: first recipients of the Visor vaccine was an African American
Speaker 1: nurse in Long Island. So they've clearly been efforts, which
Speaker 1: you've been in the center of, to have prominent trust
Speaker 1: African American voices publicly getting vaccinated. If someone sees you
Speaker 1: getting vaccinated on CNN, sure that builds trust the institution.
Speaker 1: You represent all the things you're talking about. But at
Speaker 1: the same time, what my friends are saying, or what
Speaker 1: my neighbors are saying, or what I feel like the
Speaker 1: people I know are going to do, it's going to
Speaker 1: have such a big impact. How do you create influence
Speaker 1: at that level around vaccines? So you know, I take
Speaker 1: a lot of phone calls, I answer a lot of emails,
Speaker 1: and I tell people to truth always. So when we
Speaker 1: didn't know stuff early on, Jacob, I told them we
Speaker 1: didn't know yet, we needed to give time for the
Speaker 1: studies to be completed with the vaccine trial. And then
Speaker 1: as we started to know more, we then shared more.
Speaker 1: And so what I've tried to do is to be
Speaker 1: transparent about what we don't know and open even more
Speaker 1: open about what we do know. And at no point
Speaker 1: have I asked people to deviate from those healthcare practices though,
Speaker 1: of the three ws washing your hands, wearing your masks,
Speaker 1: and watching your distance, and recently I added a P
Speaker 1: on that, so it's three ws N a P now
Speaker 1: being patient for when is your turn to receive a vaccine?
Speaker 1: And so I think it's really really critical that we,
Speaker 1: as healthcare providers and as scientists let people know that
Speaker 1: this is evolving. That's what I've tried to do with
Speaker 1: my peers is to make sure that they understand that
Speaker 1: we don't know everything, but what we do know, be
Speaker 1: confident in that we have enough smart people to help
Speaker 1: figure out most of these things. I mean, when I
Speaker 1: hear about white people who don't want to take the vaccine,
Speaker 1: I just have a gut reaction and that's irrational, that's
Speaker 1: conspiracy thinking they're anti vaxxers. I have no sympathy whatsoever.
Speaker 1: When I hear about African Americans who are reluctant to
Speaker 1: take the vaccine, I think, well, there's a whole history there,
Speaker 1: very specific things that happened in the past. Am I
Speaker 1: right to draw that distinction? Or is anti vaccine anti vaccine?
Speaker 1: I mean, are they versions of the same thing or
Speaker 1: are they different things? They are not versions of the
Speaker 1: same thing. So, you know, Jacob, if there's ever a
Speaker 1: time to understand history and to understand how that has
Speaker 1: influenced people's ability to trust a health system, the time
Speaker 1: is now. There is a book called Medical Apartheid by
Speaker 1: Harriet Washington. It is a very difficult read, but it
Speaker 1: is a book that gives you a historical perspective on
Speaker 1: what has happened from the time four hundred years ago
Speaker 1: when we were brought to this country, when blacks were
Speaker 1: brought to this country against their will, and how they
Speaker 1: were used throughout their bodies and their minds for medical experimentation,
Speaker 1: whether it was with the person who was named the
Speaker 1: grandfather of gannacology, Maryon Sims, how he used black women
Speaker 1: slave women against their will to perfect surgical procedure and
Speaker 1: they were not given anesthesia, etc. Or whether or not
Speaker 1: you're looking at how he addressed tetani in children and
Speaker 1: how he used bondage to close their sutures and their
Speaker 1: and their head that are usually closed on their own
Speaker 1: over time, or you get to more modern day times
Speaker 1: when you're talking about Tuskegee the actually we're not injected
Speaker 1: per se with syphilis. They developed syphilis, but they were
Speaker 1: not given treatment and it was intentional, right, And there
Speaker 1: are other instances. You can think about the Mississippi appendectomies,
Speaker 1: and we've had throughout the South challenges and history of
Speaker 1: women having hysterectomies performed on them without their knowledge or consent.
Speaker 1: And so while I would never be dismissive of people's concerns,
Speaker 1: what I've tried to do is address their fears. And
Speaker 1: the one way that I know to address a Jacob
Speaker 1: is to acknowledge what has happened in the past and
Speaker 1: talk about how we've learned from that for the future.
Speaker 1: And one of the things that we learned was that
Speaker 1: we needed to have trusted voices in the room, trusted
Speaker 1: voices at the table of decision when clinic core experiments
Speaker 1: were being designed, we needed to understand the science of
Speaker 1: how the disease, whatever it is, impacts one race or
Speaker 1: ethnicity or gender over another, and to make sure that
Speaker 1: those persons were represented. And then we needed to understand
Speaker 1: the social constructs in our society that prevent people from
Speaker 1: having the greatest level of access or inclusion. And we
Speaker 1: are doing that with this vaccine development and roll out,
Speaker 1: and hopefully we're going to move us from this vaccine
Speaker 1: hesitancy to vaccine acceptance. Yeah. I wonder if you can
Speaker 1: tell me a little more about your own story and
Speaker 1: how your family played into your approach to healthcare and science.
Speaker 1: I mean, so much of this comes with you. How
Speaker 1: we what we hear growing up, of course, And I
Speaker 1: just I wonder how you became so passionate about healthcare
Speaker 1: and the black community in particular. Well, you know, I
Speaker 1: was raised in a single parent household. My parents divorced
Speaker 1: when I was six, three sisters, and my mother raised us.
Speaker 1: She started to work eventually in a paper factory. She
Speaker 1: worked there twenty five years, seventy three, three to eleven,
Speaker 1: eleven to seven, and became the highest ranking woman in
Speaker 1: a paper factory in making Georgia. What I saw there
Speaker 1: was resilience. I saw grit. I saw a woman who
Speaker 1: came home every morning or evening a night when she
Speaker 1: was finishing. And she only had a high school diploma,
Speaker 1: but I believe she had a PhD. In my mind.
Speaker 1: She would whisper things in our ears, Jacob, all things
Speaker 1: are possible. You can do anything. And when you're growing up,
Speaker 1: it's a nuisance because somebody's in your ear while you're
Speaker 1: trying to sleep, right, it's a nuisance. And so she
Speaker 1: was trying to instill to us what was possible. And
Speaker 1: I went to Georgia Tech based on the fact that
Speaker 1: my science teacher said, you're good in math and science
Speaker 1: and they're looking for black kids to be engineers. And
Speaker 1: I got a scholarship to go to Georgia Tech. Really
Speaker 1: didn't hardly even apply to other places, and I coopered
Speaker 1: Proctant Gams, the chemical engineer and major, and they offered
Speaker 1: me a job. And that scared me to death because
Speaker 1: I actually didn't want to be an engineer. And I
Speaker 1: looked up in an encyclopedia math, science, and people, and
Speaker 1: one of the things that had come there is medicine,
Speaker 1: and I went over to Spellman College because Georgia Tech
Speaker 1: did not have a pre mad major at that time.
Speaker 1: Told my advisor, I think I want to go to
Speaker 1: medical school. And she said, you don't seem to know
Speaker 1: a lot about going to medical school. And I said
Speaker 1: to her, I didn't know a lot about being an engineer,
Speaker 1: and that's working out okay. And so I really believed
Speaker 1: that all things were possible. So the rest is here.
Speaker 1: I decided to leave Georgia Tech with a chemistry degree.
Speaker 1: I went to Harvard Medical School and now I've had
Speaker 1: a daughter to graduate from Harvard Medical School. And so
Speaker 1: when you look at this history, I think it was
Speaker 1: built on resilience and grid. So the presence of African
Speaker 1: American medical researchers and medical practitioners at every level is
Speaker 1: crucial to establishing that greater trust. But we have a
Speaker 1: real lag there, don't we in medical school? And you know,
Speaker 1: the numbers of African Americans enrolled is going up, but
Speaker 1: it's going up slowly. And I don't even know what
Speaker 1: the statistics look like in medical research and in the
Speaker 1: development of the vaccine. But what are you able to
Speaker 1: point you there? So if you look at the Association
Speaker 1: of American Medical College is what we call the Double AMC.
Speaker 1: Black physicians account are only five percent of all physicians
Speaker 1: in this country, even though we comprise thirteen percent of
Speaker 1: the population. You will see that black females outpaced black
Speaker 1: males at a ratio of about two point five to one,
Speaker 1: with there only being six hundred and nineteen black males
Speaker 1: who enter medical school in twenty nineteen. Now understand what
Speaker 1: that does in a classroom setting. Imagine I'm in a
Speaker 1: classroom with one hundred, one hundred and twenty five students
Speaker 1: and there are there's one black male, and let's say
Speaker 1: that there are nine black females. Lots of medical school
Speaker 1: classes now occur in small groups, and let's just say
Speaker 1: that we're talking about gun violence, and so these medical
Speaker 1: students are forming an opinion about gun violence. And a
Speaker 1: lot of that opinion doesn't just come from the litera tour.
Speaker 1: It comes from the conversations that are had in those
Speaker 1: small groups. Now, you may say, well, how does that
Speaker 1: impact my care delivery? Well, let's say I'm now on
Speaker 1: the trauma team at Grady Hospital and every person that
Speaker 1: comes in is a black male with a gunshot woman
Speaker 1: Not only am I bias from the fact that in
Speaker 1: my small classroom setting, I haven't had the opportunity right
Speaker 1: to have conversation with a black male student who may
Speaker 1: have never been involved with gun violence, but it is
Speaker 1: also affirmed for me when I get into the clinical setting.
Speaker 1: That is why diversity by race, ethnicity, gender, socioeconomic status, religion,
Speaker 1: sexual orientation is so critical to how we educate and
Speaker 1: train and how we remove ourselves. I'm a biases and
Speaker 1: are able to be more inclusive in our thoughts and
Speaker 1: our care delivery. Yeah, I have seen some studies that
Speaker 1: maybe as high as a third or thirty five percent
Speaker 1: of African Americans say they don't intend to get vaccinated
Speaker 1: or don't trust the vaccine. When people say that, what
Speaker 1: are they afraid of? Specific? When you say why won't
Speaker 1: you get the vaccine? Do you what do you hear about?
Speaker 1: Most of the time, really, Jacob, they go back to
Speaker 1: the trust because they say, you know, it's hard for
Speaker 1: me now sometimes to get access to the highest quality
Speaker 1: of care. So why would I believe that somebody is
Speaker 1: really ready to give me access to a vaccine that's
Speaker 1: supposed to be great? And so it is about building
Speaker 1: that trust. We did a vaccination program with civil rights
Speaker 1: leaders seventy five and above and Bassada, Andrew Young Herey,
Speaker 1: Hank Thomas Herey, Aaron and his wife Billy Aaron, doctor
Speaker 1: Lewis Sullivan, previous Secretary of HHS, previous president of more
Speaker 1: House School of Medicine. Those people were around when Tuskegee occurred.
Speaker 1: Those people actually lived through that history. Yet they were
Speaker 1: willing to step up and get vaccinated because they believe
Speaker 1: in science and because it was linked to more House
Speaker 1: School of Medicine, that trusted entity. Yeah, when you project forward,
Speaker 1: say a year from now, when with hopefully you know,
Speaker 1: vast majority of the population vaccinated and the pandemic if
Speaker 1: it still exists, is a very manageable kind of problem.
Speaker 1: Do you think we'll look back and say this, the
Speaker 1: vaccine was a success story in relation to people of
Speaker 1: color and to African Americans in the sense that there
Speaker 1: wasn't a lag in when they got vaccinated the proportion
Speaker 1: in which they got vaccinated. Do you think we're gonna
Speaker 1: eliminate that disparity, just as we utterly failed to eliminate
Speaker 1: the disparity the historic disparity reflected in who got the
Speaker 1: disease and who suffered most from it. So I look
Speaker 1: at this in two ways, Jacob. What I believe we
Speaker 1: will do is we will say the vaccine did what
Speaker 1: we expected it to do. Along with the other healthcare
Speaker 1: preventaged strategies of the three WS, the vaccine helped us
Speaker 1: to mitigate the disease because first you're going to see
Speaker 1: decrease in death, then decrease in hospitalizations, but not necessarily
Speaker 1: rapid decrease in cases. Now, what the what I want
Speaker 1: to look back and say the virus did it though,
Speaker 1: was it showed us the chronicity of health disparities and
Speaker 1: health in eques in this country. And as my daughter
Speaker 1: would say, it woke all of us up to how
Speaker 1: we should create interventions that are sustainable such that we
Speaker 1: never are here again. So that when we think about
Speaker 1: innovations that we will develop in cancer and diabetes and
Speaker 1: heart disease, that we will ensure the appropriate dissemination and
Speaker 1: allocation of that intervention and discovery to communities that have
Speaker 1: been left behind, ensure that people who are disproportionate impacted
Speaker 1: have access to those interventions. That we will understand the
Speaker 1: impact of social determinants that you can't be talking to
Speaker 1: people about, oh, you should exercise three times a week
Speaker 1: and go get this medication field if they're not in
Speaker 1: a safe neighborhood or if they don't have a job,
Speaker 1: so that we will understand how social determinants influence access
Speaker 1: to care and quality of care. Doctor Montgomery Rice. We
Speaker 1: always like to wrap up unsolvable by talking about things
Speaker 1: listeners can do, and in this case, I think the
Speaker 1: question is what can people do to help build trust
Speaker 1: in the vaccine. I think that people should do due
Speaker 1: diligence and listening and finding trusted advisors to help them
Speaker 1: understand the signence. Now I'm not saying they need to
Speaker 1: understand how a vaccine works, because we all take many
Speaker 1: of us take the flu vaccine right and we don't
Speaker 1: necessarily know how the flu vaccine works. But what we
Speaker 1: have done is that we have found a trusted advisor,
Speaker 1: usually in our healthcare provider, that helps us to feel
Speaker 1: more comfortable we're taking that vaccine. So I want to
Speaker 1: continue to stress to people to go to trusted sources
Speaker 1: so that they can understand the benefits of the vaccine.
Speaker 1: The second thing that I would ask them to do
Speaker 1: is to continue the three ws, washing their hands, watching
Speaker 1: their distance, and wearing their masks. Because if you do
Speaker 1: that and then you are patient, your time for the
Speaker 1: vaccine will come. But in the meantime you will decrease
Speaker 1: your chance of being a case, a hospitalization of death.
Speaker 1: And then the third thing that I will say is
Speaker 1: that we need to recognize that we have the power
Speaker 1: in this country to do most anything. Recognize who your
Speaker 1: circle of influence is, and continue to have open conversations
Speaker 1: about what got us here, but left not let the
Speaker 1: past holders back from realize in our bright future. Doctor Mortcommress,
Speaker 1: I gotta tell you made me feel really good watching
Speaker 1: you get your shot out to see you're afraid of needles,
Speaker 1: just like I am. And I saw you doing the
Speaker 1: same thing I do, which is look away from the needle.
Speaker 1: About the dean of a medical school and a doctor
Speaker 1: has the same phobia, maybe it's pretty normal. And then
Speaker 1: let me just tell you it hurt way less than
Speaker 1: the flu vaccine ever heard. So it was it was
Speaker 1: like nothing. I was like, oh my god, don't even
Speaker 1: like to watch a needle going into someone else's arm.
Speaker 1: I kind of just closed my eyes. Well, I don't
Speaker 1: mind putting the needle in somebody else bothered it just
Speaker 1: I just don't want it in my arm. Yeah, well,
Speaker 1: I wish you were here to give me a vaccine,
Speaker 1: but I think I'm gonna have to wait my turn
Speaker 1: right well, and certainly rather have my vaccine at more
Speaker 1: house medical college than at a pharmacy. Is there any
Speaker 1: way to influence where we get these vaccines, you know?
Speaker 1: So we have been in discussions with our Department of
Speaker 1: Public Health, and I know other leaders around the country
Speaker 1: who run medical schools like I do, have been in
Speaker 1: conversations with their Department of Public Health, so talking about
Speaker 1: how do we make it more readily available to the public.
Speaker 1: And one of the things that we're planning to do
Speaker 1: here is to have these vaccine vaccinations in our parking
Speaker 1: lot drive through vaccinations every Saturday for the month of January.
Speaker 1: We're also going to use our mobile research van to
Speaker 1: set up in many of the rural areas in the
Speaker 1: state to be able to offer vaccinations. So we are
Speaker 1: encouraging the departments of public Health to partner with grassroots organizations,
Speaker 1: fairly qualified health clinics to really be able to get
Speaker 1: these vaccinations to the public versus the public having to
Speaker 1: come to an establish hospital setting where people are overburdened
Speaker 1: right now with COVID cases, so that they can really
Speaker 1: get their vaccines. But I also would say to your
Speaker 1: listeners there are vaccine trials still going on, so right
Speaker 1: now I'm more House School of Medicine and at several
Speaker 1: other places throughout the country, the novavax vaccine trial that
Speaker 1: is going on, So look that up. You can go
Speaker 1: and find it on an NIH site. And rolling a trial,
Speaker 1: you got a fifty percent chance you're going to get
Speaker 1: the vaccine versus getting to placebo. And so I would
Speaker 1: say try it. Well. Thank you so much for joining
Speaker 1: us Unsolvable, and thank you doctor Montgomery Rice for your
Speaker 1: leadership in helping America get vaccinated to end this pandemic
Speaker 1: as as soon as we can. Oh, thank you, I
Speaker 1: appreciate it. Doctor Valerie Montgomery Rice is the President and
Speaker 1: Dean of the more House School of Medicine. Be sure
Speaker 1: to check out our show notes for links to the
Speaker 1: facts about COVID nineteen vaccines that you can share with
Speaker 1: friends and family. Next week, Unsolvable, we'll talk about how
Speaker 1: to make and break habits. It's a season of resolutions,
Speaker 1: but really setting yourself up to make changes in your
Speaker 1: life and behavior can happen anytime of year. Please join
Speaker 1: us for our conversation about achieving your goals, and here's
Speaker 1: a preview. It starts with friction Solvable. Senior producer is
Speaker 1: Jocelyn Frank, Booking by Lisa Dunn. Our managing producer is
Speaker 1: Catherine Girardo and Mia Lobell Is the executive producer of pushkin.
Speaker 1: I'm Jacob Weisberg.